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COPD and Other Stuff This is a patient-to-patient blog to exchange information and resources…from COPD to Arthritis to Cellulites to Sarcoidosis to Sleep Apnea to RLS to Psoriasis to Support Groups to Caregivers and all points in between.

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Pain Medication Research at UW Medical Center and Washington State University

Overdosing on pain medication can kill and may cause pain med
addiction. For COPDers though pain management isn’t
usually a part of COPD (Chronic Obstructive Pulmonary Disease)
management. Speaking as a patient – COPD isn’t painful.
Patients simply can’t breathe to different degrees and some
patients de-saturate enough to be placed on supplemental oxygen
allowing them to exercise further and faster for a quality
life.

Trouble is – COPD is often the beginning of gathering other
diseases – Other Stuff that is very painful. Trouble is –
some pain medications are known to adversely affect the respiratory
system…so too often COPDers learn to live without sleep and 24/7
pain until the day comes when the thought of facing another day of
such pain isn’t worth it and that is when a COPDer will take a pain
pill or two for relief and to sleep. Too, our physicians are
afraid to prescribe pain meds for fear their patients will become
addicted and I understand that.

I lived through the initial crushing left hip pain until now my
body is letting me help myself into better hip health through water
exercise but the ongoing debilitating cellulitis/Venous Stasis
Dermatitis/Lymphedema sweeping lower leg pain finally sent me in
desperation to the University of Washington’s Pain Management
Clinic. On one visit I listed the pain as a 9 out of 10 being
the worst.

Those were a few bad years, now is now and it is better.
For the Lymphedema, education was the key. Thanks
Melissa. Time and exercise is helping me live in harmony with
my hip… all without pain medications.

That said, UW Medicine’s Alex Cahana, M.D., DAAPM,
FIPP and the Division of Pain Medicine is
doing ground-breaking work in pain management education for the
physician and patient. He was deeply involved with the
“Washington State Opioid Reform Initiative, which
seeks to reduce the over-prescription of narcotics.”

*******

“Since then, we’ve learned of two initiatives to help providers
grapple with the disparate problems of addiction and pain
management. ROAM (the Rural Opiate Addiction
Management) Collaborative seeks to help manage the widespread issue
of opiate addiction in rural Washington. COPE
(Collaborative Opioid Prescribing Education) is an online
educational tool that helps providers communicate to patients about
how best to manage treatment of chronic, non-cancer-related
pain.

ROAM and ECHO: Defeating Opiate Addiction in Rural
Washington

Until recently, rural physicians have had few tools to help
their patients escape opioid addiction — an epidemic health issue
in rural areas, with large numbers of unintentional overdoses, even
deaths. Methadone maintenance therapy, the most common treatment
for opioid addiction, is often unavailable. However, a federally
approved medication called buprenorphine (also known as Suboxone or
Subutex), is more readily available, and it’s a viable,
office-based alternative to methadone.

Despite the potential advantages of buprenorphine as opioid
replacement therapy for addicted patients, however, few physicians
have taken the eight-hour course that allows them to legally
prescribe this medication. As of 2010, only 32 rural doctors in
Washington had received the federal waiver that allows them to
prescribe Suboxone.

In late March, Roger A. Rosenblatt, M.D., MPH, UW
professor and vice chair of the Department of Family
Medicine, and UW Medicine’s ROAM (Rural Opiate Addiction
Management) Collaborative helped remedy the situation by offering
the course to rural physicians and members of their practice staff
in Spokane, in conjunction with the annual Regional Rural Health
meetings. Physician participants are then eligible to receive a
waiver from the Drug Enforcement Administration to
allow the prescription of buprenorphine to treat addiction. If they
wish, they can also receive further mentoring and instruction from
Project ECHO (Extension for Community Healthcare Outcome), a
bi-weekly video-conferencing program that covers issues such as
patient management, staff training and clinical protocols.

For more information on ROAM — a collaboration between
Washington State University and the University of Washington,
funded by the state’s Life Sciences Discovery Fund — contact
Rosenblatt at 206.685.1361 or rosenb@uw.edu.

COPE: Online Education for Chronic Opioid
Therapy

UW Medicine has launched an online medical training tool for
doctors and other prescribing providers who treat chronic pain.
Known as COPE — Collaborative Opioid Prescribing Education — the
tool is designed to improve interactions between prescribers and
patients as they make shared decisions about chronic opioid
therapy.

COPE was developed over the past six years by Mark
Sullivan, M.D., Ph.D., a professor in UW Medicine’s
Department of Psychiatry and Behavioral Sciences
and adjunct professor of bioethics and humanities, and it has been
clinically tested and peer-reviewed. It’s a comprehensive program,
one that goes beyond typical factual content by using videotaped
clinical scenarios to train providers about goal-setting and
communications skills. Tutorial models are in development for
nurses and for patients and families to help enhance their
engagement in decision-making.

COPE focuses on the management of chronic, non-cancer pain, and
its interactive modules are a timely response to legislative
changes concerning chronic opioid therapy. Recently, Washington
State adopted a bill that requires mandatory education and use of a
prescription-monitoring program and clinical tracking tool. In
addition, the U.S. Food and Drug Administration
intends to issue a Risk Evaluation and Mitigation Strategy (REMS)
which likely will call for a coordinated risk management plan for
patients taking long-acting opioids. COPE will help prescribing
providers nationwide to meet this challenge.”

Purdue Pharma recently announced it is conducting clinical trials on OxyContin in children. Immediately some have criticized, suggesting that the exposure to opioids at an early age will inevitably lead to addiction later in life. The larger issue that was missed is that there are times opioids are necessary for children. Children in intensive care units, emergency rooms, post operatively or in rehab often require strong analgesics. These are children with cancer, with severe burns, with sickle cell anemia or other conditions. It would be cruel and inhumane to leave children untreated who experience extraordinary amounts of pain. Of course opioids should not be the first line of therapy if an alternative is available, but they may be the only way to provide relief. So the question is not whether opioids should be used in children but rather how to use them safely when they are necessary. The only way we can know how to safely use medications in children is if they are studied in children. Science should inform patient safety.

Google suboxne, there are so many people addicted to this highly addictive medication and so few Doctors care to admit to it. Suboxone is a very addictive medication despite the fact it has no opiates. I and thousands of people have attempted to quit suboxone and have realized you cannot just quit, google the weisman method, they charge $20 grand to ween people off this powerful and addictive drug. Please do not use it unless you want to trade one addiction for another.

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About This Blog

This is a patient to patient blog to exchange information and resources...from COPD (Chronic Obstructive Pulmonary Disease) to Arthritis to Cellulites to Sarcoidosis to Sleep Apnea to RLS to Psoriasis to Support Groups to Caregivers and all points in between. Written by Sharon O'Hara.